Iowa Medicaid announced that it will transition its outpatient pharmacy benefit from managed care to the state-administered fee-for-service program beginning Dec. 1, 2026.
Under this move, outpatient pharmacy claims will be processed through a single statewide pharmacy benefit administrator, Optum Rx, and paid directly by Iowa Medicaid, removing the benefit from the control of individual managed care organizations and their PBMs. The transition will consolidate pharmacy benefit administration across Iowa Medicaid and establish a single claims submission process for pharmacies serving its members.
Read the announcement here.
NCPA
